Provider Demographics
NPI:1093471906
Name:OPPONG, ROSELINE TUTUAA
Entity Type:Individual
Prefix:
First Name:ROSELINE
Middle Name:TUTUAA
Last Name:OPPONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 S 248TH ST APT A15
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4063
Mailing Address - Country:US
Mailing Address - Phone:425-524-1570
Mailing Address - Fax:
Practice Address - Street 1:2531 S 248TH ST APT A15
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4063
Practice Address - Country:US
Practice Address - Phone:425-524-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator